Help with blood test results

Hi all,

I have just had my appointment with my endocrinologist and my results are definitely unusual for me!! Please could anyone help interpret them for me? I currently take 200mcg levo but no T3 at present after my endo advised me to stop taking T3 and just take levo in order to raise FT4 levels.

My recent results are:-

TSH 0.08 (0.35 - 4.5)

FT4 16 (11 - 26.0)

FT3 3.4 (3.1 - 6.8)

I have been advised to reduce my levo to 175 daily and add in 10mcg T3 three days per week. My only trouble is my heart is doing very funny things (palpitations, high heart rate at the gym when I am reasonably fit and not pushing myself too much). I would really appreciate any advice as I am a bit worried. Thank you so much for your help,

C xx

[greygoose]

I find it very odd to give T3 three days a week and leave you T3less for the other three days. Considering how endos often go on about mimicking the natural production of T3 - and therefore telling you to take it three times a day - I wonder how they justify just giving it three times a week.

The body needs a constant and steady supply of T3, as it is the active hormone - although it's ok to do that sort of thing with T4, which is a storage hormone. And, considering that you don't have a very high level of T4 to convert, I would have thought you would be better off with 10 mcg every day.

Your endo's attempts to raise your FT4, obviously failed! What does he think about that? Does he think it normal to have such a low level of FT4 on 200 mcg of levo? And, why does he think that someone taking T4 needs a higher level of FT4, anyway? I don't think he really knows what he's doing.

[Hidden in reply to greygoose]

Thank you for this greygoose. To be honest, I'm scratching my head about it all. I agree, I was very surprised when my endo told me to take T3 three times a week, but I don't have any better ideas and I am fearful of doing anything contrary to his advice because I don't know what else to do.

I'm really puzzled as to why my FT4 levels are still low despite 200mcg of levo and I am also unsure as to why my FT3 levels remain low. I know my endo was concerned I wasn't absorbing the levo properly to start with as I have colitis, hence a higher dose of levo, but now I am genuinely worried, am feeling off it and don't know what to do next 🙁

[greygoose in reply to Hidden]

The FT4 is always low when taking T3. But, it would seem, only endos don't know that! It's pointless giving patients huge doses of levo with their T3 to try and raise the level. And, it doesn't matter. The body will keep what it needs and get rid of the rest. You just have expensive urine.

Your T3 is low because you aren't taking enough, and don't appear to be converting any of that T4. You need at least that much T3 every day, and cut back on the levo.

[Hidden in reply to greygoose]

I did wonder if I wasn't converting well enough. It's all so puzzling.. My T3 tablets don't have a fracture line so I am considering trying 20mcg T3 with 150mcg levo. I am just concerned that my TSH will be further suppressed and whether that will increase the palpitations I already get from time to time. Thanks once again for your help.

[greygoose in reply to Hidden]

TSH has nothing to do with palpitations. It doesn't matter how low it goes. In fact, it is totally irrelevant once you're on thyroid hormone replacement, unless it goes high (which means you're under-medicated).

You are getting palpitations at the moment, because your FT3 is much too low.

Judging by those results above, your conversion isn't brilliant, but I've seen a lot worse. But, if you have the opportunity to take T3, go ahead and enjoy. lol

[Ruthi]

The half life of T3 is around 8 hours, so effectively on non T3 days you will have none in your system.

If you don't want to upset the endo, try doing it his way for a week, and see just how you feel before deciding what you want to do. It would be perfectly reasonable to take your T3 daily and ring his secretary and tell her that you felt so awful on the days off you decided to take it daily.

Are you taking your T4 on an empty stomach with just water, and then waiting an hour before you consume anything else? Have your nutrient levels been tested? In particular Vitamins B12 and D, Ferritin and folate? I know there was a blood test where everything was 'normal' but can you get the actual figures?

I am sure I read somewhere that you had gastritis or colitis, but now I can't find the reference (or I mixed you up with someone else!) What drugs, if any, do you take? And what supplements?

[Hidden in reply to Ruthi]

I take my levo at bedtime with a big glass of water, I just remember to take meds better at bedtime, I forget in the morning!!

You are right, I mentioned above that I have ulcerative colitis. After a time in and out of hospital and on steroids and immunosuppressant meds I am now off all meds mainly due to looking after myself and eating cleanly. I do have to be careful though, it's a constant worry. I don't take any supplements apart from vitamin d once a week (1 X 20000 iu). My vitamin d is now within range but not optimal and my endo has told me to keep taking the weekly supplement. My vitamin b12 wasn't checked this time but was a very impressive result three months ago!

I'm considering taking my whole t3 tablet daily (20mcg) and dropping levo to 150mcg but I'm just so nervous about 'doing my own thing'! Thank you once again for your help.